After fighting neglected diseases in Africa for a quarter century, former president Jimmy Carter takes on one of the continent's biggest killers malaria

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Trailed by reporters, Jimmy Carter launched his antimalaria initiative in the small community of Afeta. Some 50 million Ethiopians (Kemeru Gessese washes clothes in a river) live in regions where the disease is rampant.
(Antonio Fiorente)

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His once-sandy hair had gone all white; his shoulders were a bit more stooped; his freckled face was lined with new creases. But Jimmy Carter's 82 years had diminished neither his trademark smile, which could still disarm skeptics at 20 paces, nor his enthusiasm for the long chance, which had propelled this obscure peanut farmer to national prominence in the first place. That quixotic spirit took him this past February to an impoverished corner of Ethiopia, where he would announce his most audacious crusade yet: to eliminate malaria, an elusive and ever-changing killer, from this ancient African nation of 75 million people.

Now rare in developed countries, the disease kills more than a million victims each year in the world's poorest regions. At least 300 million people worldwide are incapacitated by malaria infections. The disease's aches, fever, chills and other flu-like symptoms not only inhibit economic productivity but also suppress immune systems in its victims, making them more susceptible to tuberculosis and AIDS—both of which kill even more people than malaria does—and other life-threatening ailments.

"We can control malaria—absolutely," Carter was saying, standing in the dusty courtyard of a clinic in the village of Afeta. Vultures wheeled overhead, and farmers in faded clothes lined up to receive new mosquito nets from the hands of the former president. Dressed in a blue plaid shirt and blue jeans festooned with a silver "J.C." belt buckle, Carter noticed an old woman struggling to unpack her net. He pulled out a pocketknife, sliced open the heavy plastic packaging and presented the net to her. "There you are," he said, flashing the smile.

The nets, treated with long-lasting insecticide, cost $5 each, but the villagers got them free, courtesy of the Atlanta-based Carter Center, the Ethiopian government and a host of other donors. While the villagers collected their nets, an entourage of reporters, documentary filmmakers, Secret Service agents and Ethiopian health workers got a malaria lecture from the one-term president and Nobel Peace Prize winner, who had been making foreign forays like this one—to fight disease, monitor elections and defuse international conflict—since founding the Carter Center with his wife, Rosalynn, in 1982.

"Most of those who die from malaria are little children, 1 to 5 years old," Carter said as villagers huddled nearby, deploying their umbrellas against the rising heat. "It's been around so long that people have become inured to it. We hope to demonstrate that we can do away with malaria in a major country. It will be an example to other countries of what can be done."

Carter and his colleagues have already demonstrated what can be done in 17 African countries to prevent or treat debilitating diseases such as Guinea worm, trachoma, lymphatic filariasis, schistosomiasis and river blindness. All are classified by the World Health Organization as "neglected tropical illnesses." "What that means is that they can be prevented or eliminated with proper treatment," Carter told me. "These neglected diseases have disappeared in most of the developed world. In just a few years we've almost eliminated Guinea worm, which has gone from three and a half million cases down to about 25,000—a 99.3 percent decrease. We treat about ten million people a year to prevent onchocerciasis, or river blindness. We're making progress with trachoma, which is the leading cause of preventable blindness in the world. We're helping to train a corps of healthcare workers through seven universities here in Ethiopia, so that even people in the most remote areas will have access to treatment. The success with these programs gives me confidence that we can have some impact on malaria."

Carter had come too late to help little Amzia Abdela, a 2-year-old who died in 2006. She had lived deep in southwest Ethiopia, where farmers still turn the earth with wooden plows and plodding oxen, where goats sleep in red dirt roads and hornbills flap languidly from banana trees.

"She was shivering," recalled the girl's father, Abdela Abawori, a farmer in the village of Keta Chole. "She had a hot fever and a headache. Her joints were aching. My daughter was sick for almost two months. By the time we called the malaria worker, it was too late." We conversed through Abate Tilahun, a program officer in the Carter Center's Addis Ababa headquarters. Abate, soft-spoken and courtly, translated from English to Amharic, a musical tongue with Semitic roots that is the official language of Ethiopia.

In short order, Abate had established that Abdela and his wife, Nefisa, 35, have six other children, including a boy born the month before. In a few weeks, the rains would come again, and Abdela would plant his maize. I asked about last year's harvest.